Strategies for Communicating with Vulnerable and Non-English-Speaking Populations: An Interview with Meredith Li-Vollmer

By Katie Regan, Communications Specialist for Environmental Health, Pandemic Preparedness, and Catastrophic Response, NACCHO

This post originally ran on NACCHO’s Preparedness Brief blog and is part of a series of interviews with local health department staff who will present at the 2015 Preparedness Summit. Meredith Li-Vollmer, PhD, Risk Communication Specialist for Public Health – Seattle and King County, previews her session, “Reaching the New America: Communication Strategies with Immigrants for Health Departments of All Sizes.” At the session, Meredith will be joined by Paulette Valentine, Director of Emergency Preparedness and Response, Southwest Utah Public Health Department; Robert Einwick, Health Protection Division Manager, Saint Paul – Ramsey County Public Health; Heather Fortner, MPA, Risk Communication Coordinator, Shelby County Health Department; and David Carney, Preparedness Coordinator/IT Manager, Montgomery County Health Department.

Q: Thanks for taking the timeheadshot-Li-Vollmer to speak with us about your workshop at the 2015 Preparedness Summit. Can you give a brief overview of what your session will cover?

Our session will address the way many communities across the nation are changing and how we as local health departments need to be able to communicate effectively during times of disaster and crisis. In particular, we’re looking at the increasing number of people across the country who speak languages other than English in the home. This session will go over some different strategies that jurisdictions of different types and sizes have come up with to be able to communicate more effectively. It will talk about suggestions for being able to communicate more effectively with immigrant residents, and also a little bit about international visitors.

Q: Why is it important for local health departments to broaden their communication strategies in such a way?

We need to make sure that we’re reaching the whole community and that we have equity in communications. Every one of our residents need to have equal access to critical health and safety information. There are also many places in the country where such an influx in languages is a relatively new thing. And for those that have a history of different language groups, there is always improvement that can be done to make sure we’re providing access to information to everyone.

Q: What are some of the challenges local health departments might face in designing equitable communications strategies?

One of the first challenges is knowing what languages are even out there. We don’t always have new enough data that can keep up with the influx of new language groups. And then, it can be challenging to figure out not only how to do interpretation and translation, but also ways to be culturally competent and culturally relevant. It’s challenging when there are so many groups to know about. We are also not always the most credible source of information for some of these groups. They might not know what public health is, or maybe they have reasons not to trust government because of experiences they’ve had in the countries they came from. Figuring out who those sources they trust are, and creating a system to be able to communicate with them is all very challenging, and time- and resource-intensive.

Q: What are some of the strategies and tools that can be used to overcome those challenges?

A number of health departments have been successful in leveraging programs already in place with different community groups for emergency communications. One of our speakers will be talking about how they’ve done that well in Kentucky. What community groups or faith-based organizations are you working with already? Do you have connections to other social service agencies that might have contacts? One strategy I’ll be talking about is our effort in using ethnic media. Many communities have ethnic media: sometimes it’s a print newspaper, sometimes they’re radio stations, or cable access television stations. Sometimes they might be really tiny. But if you can find out what kind of media exists in your community, and how you can get in contact with them, that can be a way in which you can get information out to those credible sources.

Q: In what ways has Public Health – Seattle and King County been successful in developing communications strategies that reach across audiences and communities?

We have a vulnerable populations action team we have worked with to learn what organizations serve these communities, and who they consider credible sources of information. We do use ethnic media and we’ve worked at building those relationships by setting up meetings and allowing them to meet health department staff. They depend on advertising for support, and so part of the way to develop a relationship is to buy advertising and encourage others in our county system to do the same; it’s very inexpensive and a very effective way to reach very specific populations. We also work with translation and interpretation to put our materials into other languages and most recently began using social media as a way to get out those translated messages. Sometimes it’s a challenge to do so, especially because we don’t have staff who understand the languages and who can be monitoring the messages, but at least being able to get the messages out is important. There are so many communities to learn about that is helps us to identify who might have the most influence in a community. If we can get the message to them, they can help disseminate it.

Q: What is the biggest “lesson learned” you can share from your own efforts to reach audiences outside of the mainstream, and to develop culturally appropriate risk communications?

One of the things I learned early on is that translation alone is not sufficient. We used to translate our flyers and fact sheets and think, “Okay, we’ve done our job.” And really, that’s just one part of it. We need to make sure the messages really are relevant to the population we’re trying to reach. An example is our experience with H1N1. In our communications with the public, we began using the term “swine flu” because H1N1 was not a term that  stuck with the general population. And soon, we heard from leaders in our local Somali community that associating vaccines with pigs was really harmful because people in the Muslim religion find anything associated with pigs to be taboo. So we thought, “Okay, we need to change our wording.” And then Somali leaders then told us that community members thought there was pig product actually in the vaccine. At first we thought, well there’s no way that there is, but we did a little work and found out there’s a tiny amount of porcine gelatin in the vaccine as a preservative. We did a little more work and found out there’s porcine gelatin in other vaccines as well. So, it was good to have this relationship with the local community leaders. We were able to get feedback on our messages, and in this situation, realized we had a much larger issue to address.

Because of that relationship, we were able to find vaccines that did not have the porcine gelatin and work with Somali leaders at the local mosque. They demonstrated to their community the vaccine’s safety by getting it themselves.

Q: Can you tell us a little about what the other panelists will be covering in their portion of the presentation?

Paulette Valentine from Utah will talk about their robust plan to communicate with international tourists. Robert Einwick from St. Paul will talk about the work he’s been doing with ECHO Minnesota to build cultural service units as a way to get information out among Somali and Latino communities. Heather Fortner is going to be talking about some of the low-cost strategies they’ve used in Shelby County to get emergency communications out. And then David Carney from Montgomery County will talk about how they were able to leverage an existing health program for Latino residents to help plan safe havens during storms.

Q: What are you looking forward to most at this year’s Preparedness Summit? 

I always enjoy reconnecting with my colleagues around the country. I’ve been going long enough now that there are a number of people who I only get to see at this event who I’m really looking forward to catching up with.

The early bird deadline for the 2015 Preparedness Summit is Friday, March 6. The summit is the premier national public health preparedness conference and provides one of the only cross-disciplinary learning opportunities in the field. Learn more and register at Read more posts like this one on the Preparedness Brief blog at


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